What is coronary artery disease?
The heart is a muscle that pumps blood. Like all muscles, the heart needs a steady supply of blood to work. Blood that pumps through the heart doesn't feed the heart muscle. Instead the heart muscle is fed by its own arteries. These arteries are called coronary arteries.
Coronary artery disease (heart disease) happens when blood flow through the coronary arteries is partially or totally blocked.
Coronary artery disease is the main cause of angina, unstable angina, and heart attack
You're more likely to have coronary artery disease if you're older, male, or have a parent or grandparent who had coronary artery disease before they were 50
The most common cause is hardening of the arteries (atherosclerosis)
Unstable angina and heart attack can cause an abnormal heart rhythm or cause your heart to stop. You can die if you aren't treated quickly. Also, a heart attack causes permanent heart damage.
Supplying the Heart With Blood
Like any other tissue in the body, the muscle of the heart must receive oxygen-rich blood and have waste products removed by the blood. The right coronary artery and the left coronary artery, which branch off the aorta just after it leaves the heart, deliver oxygen-rich blood to the heart muscle. The right coronary artery branches into the marginal artery and the posterior interventricular artery, located on the back surface of the heart. The left coronary artery (typically called the left main coronary artery) branches into the circumflex and the left anterior descending artery. The cardiac veins collect blood containing waste products from the heart muscle and empty it into a large vein on the back surface of the heart called the coronary sinus, which returns the blood to the right atrium. |
What causes coronary artery disease?
The most common cause of coronary artery disease is atherosclerosis, commonly known as hardening of the arteries. In atherosclerosis, cholesterol and other fatty material slowly build up in your arteries. This build-up is called an atheroma or plaque. The plaque may:
Narrow the artery, partly blocking blood flow to your heart
Rupture suddenly, causing a blood clot that blocks the artery and causes a heart attack
Less common causes
What are the risk factors for coronary artery disease?
Risk factors that you can control or avoid:
Smoking cigarettes
Being overweight
Not exercising regularly
Eating too much saturated fat, such as butter, and not enough fruits and vegetables
Risk factors that are important but can't be controlled:
Having people in your family who had coronary artery disease before age 55
Being a man
Growing older
How can doctors tell if I have coronary artery disease?
Your doctor will ask you questions about your symptoms and do a physical exam and blood tests.
If you have symptoms of a blocked artery, your doctor may do tests:
Stress test—a test to see whether your heart is getting enough blood when it works hard (is under stress), such as when you exercise
ECG/EKG (electrocardiography)—a test that measures your heart’s electrical activity, which can be abnormal in coronary artery disease
Cardiac catheterization—a test that allows doctors to see if and where your coronary arteries are blocked by putting a long, thin catheter (small flexible tube) into an artery in your arm or leg, up to your heart, and into your coronary arteries and then injecting contrast material that is seen on x-ray
CT (computed tomography) scan—an imaging test to look for hardening of the coronary arteries
How do doctors treat coronary artery disease?
Doctors treat the problem that's causing your coronary artery disease, which is usually hardening of the arteries. They may:
Give you medicine to lower the workload on your heart, such as blood pressure medicine
Give you medicine to lower your cholesterol level
Ask you to change any unhealthy behaviors that may hurt your heart—for example, smoking, not exercising, and eating a poor diet
Sometimes do a procedure to open a blocked artery
Depending on how much your coronary arteries are blocked, doctors may do a procedure to clear your artery. They may do angioplasty or bypass surgery (also called coronary artery bypass grafting or coronary artery bypass surgery).
During angioplasty:
The doctor puts a small, flexible tube (catheter) into an artery in your upper leg (groin) or in your wrist
The catheter is pushed up the artery to your heart and then into one of your coronary arteries
A small balloon on the tip of the catheter is inflated
The balloon pushes the blockage open
Then the doctor slips a wire mesh tube (stent) off the end of the catheter into the blocked area
The wire mesh tube helps hold the blocked area open
During bypass surgery:
Doctors take a piece of healthy artery or vein from another part of your body
They sew one end of that piece of artery or vein to your aorta (the major artery that takes blood from your heart to the rest of your body)
They sew the other end to your blocked artery past the point of the blockage
Your blood then flows through this new route, bypassing the blockage
How can I prevent or reverse coronary artery disease?
Change behaviors that may hurt your heart
Stop smoking—this is the most important way to prevent or reverse coronary artery disease
Eat healthy foods, such as fresh fruits and vegetables and other high-fiber foods
Eat less fat from meats, dairy, and processed foods (such as frozen pizza or microwaveable dinners)—talk to your doctor about how much and which types of fat you should eat
Lose weight if you're overweight
Stay active by using weights or walking
Stop using illicit drugs—this can be hard to stop, so talk to your doctor or a counselor about how to get help
Take your medicines correctly
Remember to take any medicines prescribed by your doctor, such as for high cholesterol, high blood pressure, or diabetes
